USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 33
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I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burjal or transit permit was Issued :
Walter
(Signature of Agent of Board nf Health or other)
Health Office
5/11/48
(Date of Issue of /Permit)
18 DATE OF
DEATH
( Month)
(Day)/
19 | HEREBY CERTIFY,
3-31
19 YE,
to
5-10-
19 48
I fast saw h
allve on
48 5- 9
, 19
, death is sald to
have occurred on the date stated above, at 5.45 €
.m
Immediate jause of death
Due to
Due to.
Other conditions.
( Include pregnancy within 3 months of death)
Mejor findings: Of operations
Date of
Of autopsy
What test confirmed dlegnosis?
IMPORTANT
Physician Underline the cause to which death should be charged v .. tistically .
20 Was disease or injury in any way related to occupation of deceased?
Il so, specify A Mua
mas
( Signed)
. M. D.
(Address) Y Unday
Date 5-10-1948
21 Joevar 7 Boston Place of Burial, Cremation of Removal. (City or Town)
DATE OF BURIAL
may 12
19
48
22 NAME OF
Edw. M .- Fitzgibbon
UNE
ADDRESS
1428 Dorcheaty Dve Doucheati
Recalved and Alled
MAY 1 3 1948
.19.
( Registrar)
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. PARENTS
100m-(g)-1-45-15510
(Official Designation)
(City or Town) S Registared No. Winthrop Community Hosp. No. { (If death occurred in a hospital or institution. { give its NAME instead of strect and number) - PLACE OF DEATH
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
11000-
yeara
1
months
9
days.
In this community 1 2 yrs.
mon.
days.
MEDICAL CERTIFICATE OF DEATH
10 1948 (Year)
Thet I attended deosased from
Duration
IMPORTANT ....
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a persou whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has heeu engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not heen huried, until he has received a permit from the hoard of health, or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiving tomb to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall he accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such hody shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such hody has heen sooner ohtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given aud the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the hody of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human hody or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the hody is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morhid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
R-302
1
PLACE OF DEATH
SUFFOLK BOSTON
(City or Town) Boston City Hospital No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
. (City or town making return)
Registered No.
445489
(If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
2 FULL NAME
Vincent Fischer
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoo. No.
22 Pleasant Pk Rd
St.
Winthrop
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: in hospital or institution ...
(Before death)
(Specify whether)
years
months
6 days.
In this community
25 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
DIVORCE
Married
(Month)
(Day)
(Year)
5a If married, widowed, MANvoosde Pantuo.s.co.
HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife If allve
48
years
7 IF STILLBORN, enter that faot here.
8 AGE 57 Years 11 .Months Days
If less than 1 day Hours. Minutos
Usual
9 Occupation :
Shoe worker
Industry
Shoe business
10 or Business :
11 Social Security No.
029-09-3978
12 BIRTHPLACE (City)
(State or country)
Italy
13 NAME OF
FATHER
Vincent Fischer
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Marian Farrara
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 Minnie Flacher
Informant
Relation, if any (Address) 22 Pressanti PK Rd Winthrop
ATTEST?
(Registrar of gity of town Fragte geathedecurred)
19
DATE FILED
1
Physician
Major findings :
Of operations.
Sub-total
Gastrectomy
Date
of 5/11/48
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased ?.
(Signed)
if so, speolfy.
M W O'Connell
M. D.
(Address)
B ..... C .... H.
Date 5/12 1948
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop
Winthrop
DATE OF BURIAL
ay 14 1948
19
22 NAME OF
FUNERAL DIRECTOR
E P Caggiano
ADDRESS
Winthrop
Received and filed. MAY 21 1948 19
(Registrar of City or Town where deceased resided)
50m- (b)-6-44-14607
18 DATE OF
DEATH
May 11 1948
19 1
HEREBY CERTIFY,
May 7
That I attended deceased from
1948
to
May 11
19
48
I last saw h
alive on
19.
...... , death is said to
have occurred on the date stated above, a
2:05 P
m.
Duration
Immedlate cause of death.
Due to.
Surgical shock
3 hrs
Due to.
Carcinoma of stomach
4 mo
Other conditions.
(Include pregnancy within 3 months of death)
Underline the cause to which death should be charged sta· tistically.
(City or Town)
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-808 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
(If U. S.
War Veteran, WW I
speolfy WAR)
Date of entering military service June 24 1918 Date of discharge Rank, rating Organization and outfit Service number
Jan 24 1919 Private Co E 42 Infantry Camp Upton NY 2726727
R-302
1
PLACE OF DEATH
Suffolk (County)
Boston
(City or Town)
Mass.General Hospital
(If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
2 FULL NAME
Lena Rahlan
(If deceased is & married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
149 Locust
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months
1
days.
In this community
11 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
F
4 COLOR OR RACE|
W
5 SINGLE
(write the word)
Married
18 DATE OF
DEATH
May 11/48
(Month)
(Day)
(Year)
19
May 10
HEREBY CERTIFY, 19.48
That I attended deceased
from
May
11
19
48
I last saw h
er ...
allve on
to
May 11
48
death is said to
(or) WIFE of
(fixe maiden name of wife in full)
(Husband's name in full)
have occurred on the date stated above, at
m.
Duration
Immediate cause of death
Brain tumor
At least
7 IF STILLBORN, enter that faot here.
AGE.
8 40 Years Months Dayı
If less than 1 day
Hours.
.Minutes
Usual
9 Occupation :
Housewife
Industry 10 or Business :
11 Social Security No ..
12 BIRTHPLACE (City)
(State or country)
England
PARENTS
15 MAIDEN NAME
OF MOTHER
Mary Goldstein
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Informant. (Address)
Father (
Relation, if any
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
.May ..... 14
/19 48
22 NAME OF
B Birnbach
FUNERAL DIRECTOR
Dorchester ass.
ADDRESS
Received and filed
MAY 21 1948
19
(Registrar of City or Town where deceased resided)
1
DATE OF BURIAL
May 12/48
(City or Town)
19
If so, speolfy
F
Haase Jr.
(Signed)
(Address)
Mass."eneral Hospt
Date
5-12%
48
21 PLACE OF BURIAL,
CREMATION OR REMO
(Cemetery)
Bride of Boston-Woburn ass.
Underline the cause to which death should be charged sta- tistically.
Of autopsy
autopsy
What test confirmed diagnosis?
No
20 Was disease or Injury in any way related to oooupation of deceased?
Physician
Major findings :
Of operations
Craniotomy
May 10/48
Date of
1 Month
XXX.Type undetermined
Due to
Other conditions
(Include pregnancy within 3 months of death)
13 NAME OF
FATHER
Benjamin Babson
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
50m-(b) -6-44-14607
resided ih another city of towh at the time of death should be made forthwith and transmitted on Form R-802 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
4424 90
(If U. S.
War Veteran,
specify WAR)
Winthrop
Dass.
(Usual place of abode)
MARRIED
WIDOWED
or DIVORCED
5a if married, widowed, or divorced
HUSBAND of
7;3009
6 Age of husband or wife if allve
41
years
-301 A +
Suffolk
6/2/48
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
91
No. WinthropCommunity Hospital St. { give its NAME instead of street and numher)
BABY BOY PEPi
2 FULL NAME (If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 356 Beach St., Revere, Mass. (Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
( Specify whether)
Jeers
months days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3. SEX
Fale
4 .,COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
5e If married, widowed, or divoroed HUSBAND of
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive
yeers
7 IF STILLBORN, entar that fact here. StillBORN
8 AGE Years Months Days
If less then 1 dey Hours Minutes
Usual 9 Occupetion :
Industry
10 or Business :
11 Social Security No.
Winthrop
12 BIRTHPLACE (City)
(State or country)
Mass
13 NAME DF
FATHER
John F. Pepi
Mejor findIngs:
Df operations
Date of
Of eutopsy
What test confirmed dlegnosis?
IMPORTANT
Physician Underline the cause to which death should he charged sta- tistically
20 Was disease or injury in any way related to oogupation of deceased ?
If so, spaoify.
( Signed).
Maurice 0.
Delow
( Address)
-199 864 SKay GoDager 5/14 1948
21
Holy Cross Cemetery
Halden
DATE OF BURIAL
May
17
19
22 NAME DF
FUNERAL DIRECTOR
William. Lepi
ADDRESS
971 Saratoga St. Las. Boston.
Received and Aled. 19
MAY 17 1948
(Registrar)
1
1
PLACE OF DEATH
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effeot.
100m. (g)-1-45-15510
(Signature of Agent of Board of Health or other) Reality Office
5/17/48
(Date of Issue of Permit)
18 DATE DF
DEATH
Maul.
14,
1948
( Month)
(Day )
(Year)
19 | HEREBY CERTIFY,
19.
19
Thet I attended deosased from
i last sew h
alive on
19
death is sald to
have occurred on the date stated above, at
m.
Immediate oause of death
FETAL DEATH IN UTERO
Dua to
Due to.
Other conditiona.
( Include pregnancy within 3 months of death)
14 BIRTHPLACE OF
Salerno
FATHER (Clty)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Do thy Gillis
16 BIRTHPLACE OF
Revere
MOTHER (City)
(State or country)
Mass.
17 John F ...... P.e.p.i ...
Informent. ( Address) 556 Beach St Revere
Relatlon, If any
( Father
I HEREBY CERTIFY that a satisfactory standard certificate of deeth was fled with me BEFORE the burial or transit permit was Issued : Walter 4.Makers
....
PARENTS
( County)
Winthrop (City or Town)
Registered No.
S (If death occurred in a hospital or institution.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
1
Duration
IMPORTANT .- about 1415
Place of Burial, Cremation or Romo
I.
(City or Town)
48
(Oficial Designatton)
( write the word)
(Give maiden name of wife In full)
1
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place hetwecn February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been huried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomh to another in the same cemetery, until he has received a permit from the hoard of health or its agent aforesaid or from the clerk of the town where the body is huried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may he, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall he accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such hody has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it aud transmit it to the clerk of the town for registration. The person to whom the permit is so given aud the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the hody of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall hury a human hody or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to he buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is ahsent from home wben the certificate of death is needed.
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